For the first time, a prospective and complete documentation of rare diseases was implemented at a German university hospital. The prevalence of rare diseases of 6 to 8% as defined by the European Union was exceeded several fold. Probably it underestimates the actual prevalence considerably, since the quality of the coding correlates on user compliance. Nevertheless, the results of this survey underline the special role of patients with rare diseases in the medical care at university hospitals.
For the first time, a prospective and complete documentation of rare diseases was implemented at a German university hospital. The prevalence of rare diseases of 6 to 8% as defined by the European Union was exceeded several fold. Probably it underestimates the actual prevalence considerably, since the quality of the coding correlates on user compliance. Nevertheless, the results of this survey underline the special role of patients with rare diseases in the medical care at university hospitals.Patients are increasingly using social media and review sites to get information on hospitals, to rate them or to write a review about their own experiences during hospital stay. Hospitals have the opportunity to use these patient reviews for internal quality assurance as well as online reputation marketing.
The objective is to analyze the satisfaction ratings of previous hospitals stays by social media users on platforms such as "Google", as well as reviews from the German site "Klinikbewertungen.de", and to compare them.
User reviews (n=16,691) for all hospitals (n=180) in the federal state of Lower Saxony (complete survey) for 2013-2018 were extracted from the platforms Google and the German Klinikbewertungen.de. Subsequently, a descriptive and inductive analysis (Chi?-test) of the user reviews and a comparison specific for the platforms were completed.
Most users are satisfied with their hospital stay, whereby users of the platform Google ratd their hospital stay worse (n=6,181; 57.6% satisfied) tve, namely private or statutory. Online reviews and ratings for hospitals may be used for internal quality assurance or improvements of company online reputation.The aim of this study was to explore caregiving situations and to identify highly burdened caregiver groups.
Survey data was collected from 1,429 family caregivers. Family caregivers were defined as relatives, friends, or neighbors who take care of and look after a person in need of care. Cluster analysis identified groups of family caregivers. Group differences were tested for statistical significance using the chi-squared test and analysis of variance.
Five groups of family caregivers were identified based on their caregiving tasks. Groups were characterized by the care situation (relationship to the person in need, intensity, and duration of care) and socio-demographic factors (gender, age, and employment). Groups differed in the perception of the care-related burden. While emotional burden was high in almost all groups, caregivers who provided everyday care reported high physical burden and those who provided continuous care over a long period reported high financial burden.
Caregivers are not a homogeneous group. They take on different roles and are exposed to various health and financial burdens. Information and services need to be addressed target group specifically. The presented typology supports health insurances and municipalities by enabling effective support approaches for highly burdened groups of family caregivers.
Caregivers are not a homogeneous group. https://www.selleckchem.com/products/gc376-sodium.html They take on different roles and are exposed to various health and financial burdens. Information and services need to be addressed target group specifically. The presented typology supports health insurances and municipalities by enabling effective support approaches for highly burdened groups of family caregivers.?During endoscopic retrograde cholangiopancreatography (ERCP), access to the common bile duct (CBD) can be problematic after unintentional insertion of the guidewire into the pancreatic duct. We conducted a prospective, randomized study in order to compare biliary cannulation success rates of early double-guidewire (EDG) and repeated single-guidewire (RSG) techniques in patients with inadvertent passage of the guidewire into the pancreatic duct.
?Patients with a native papilla were randomly assigned to either the EDG or RSG groups after unintentional insertion of the guidewire into the pancreatic duct. The primary outcome was successful selective CBD cannulation within 10 minutes. The secondary outcomes were successful final selective bile duct cannulation, time to bile duct cannulation, and frequency of post-ERCP pancreatitis (PEP).
?142 patients were randomized and selective bile duct cannulation was achieved in 57/68 patients (84?%) in the EDG group and in 37/74 patients (50?%) in the RSG group within 10 minutes (relative risk 1.34; 95?% confidence interval 1.08-6.18; ?&lt;?0.001). The overall final selective bile duct cannulation rate was 99.3?%. The time to access the CBD was shorter using the EDG technique (6.0 vs. 10.4 minutes; ?=?0.002). Mild PEP was not observed more frequently in the EDG group than in the RSG group.
?The EDG technique significantly increased the success rate of biliary duct cannulation within 10 minutes compared with an RSG approach.
?The EDG technique significantly increased the success rate of biliary duct cannulation within 10 minutes compared with an RSG approach.BACKGROUND? This study evaluated an oroenteric catheter (OEC)-assisted technique to distend the enteric loop for endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in patients with gastric outlet obstruction (GOO). METHODS? Patient outcomes were reviewed. Proximal enteric loops were filled with water via an OEC (7 Fr or 8 Fr), providing a target for EUS-GE using a lumen-apposing metal stent (15-mm caliber). Clinical success was defined as toleration of a non-liquid diet by Day 3. RESULTS? 42 patients (mean age 73.1 [SEM 2.8] years; 23 male) underwent EUS-GE for malignant (n?=?37) and benign (n?=?5) duodenal strictures. EUS-GE creation was successful in 41/42 (98?%), with mean procedure time of 36 (SEM 3) minutes and no serious complications. Clinical success was achieved in 39/42 (93?%) at 5.7 (SEM 2.6) months' follow-up. Of 14 patients who died, 13 (93?%) maintained oral intake until death. EUS-GE provided good symptom relief in all 28 surviving patients until follow-up. CONCLUSIONS? OEC-assisted EUS-GE provided satisfactory relief of GOO symptoms, with high technical success (98?%) and no serious complications.